Review of treatment – Social Phobia
(Word Count 1633)
In this essay, I will be looking into the treatment approaches for Social Phobia and providing an evaluation of the literature around the efficacy of treatments relevant to this disorder.
Social Phobia, also known as Social Anxiety Disorder, is the third most common mental disorder in adults worldwide. It is an anxiety disorder where there is an evident and persistent fear of social or performance situations in which embarrassment may occur (Burstein, Grillon & Merikangas, 2011; Lane, 2007). An individual with Social Phobia may develop a significant emotional discomfort, anxiety, fear or worry about exposure to social situations that can lead to panic and the avoidance of these situations (Fehm, Pelissolo, Furmark & Wittchen, 2005).
It was first published in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980 and is a part of the Anxiety Disorders section. Social Phobia has been found to have an early onset, with the median age of onset of 16 years old, although a minority of causes involves a late onset after a significant life event such as an episode of failure. The most commonly reported fears relating to Social Phobia are public speaking, general speaking up in class or meetings, going to parties and dating (Stangier, Heidenreich, & Peitz, 2002).
Data from a New Zealand survey, the largest of the World Mental Health collaborating surveys, show that fewer than five percent of those meeting the criteria for Social Phobia seek treatment in the year of onset and only 36 percent of those with a lifetime diagnosis of Social Phobia sought treatment from a health professional at some stage (Titov, Andrews, Choi, Schwencke & Mahoney, 2008).
There are a number of treatment options for Social Phobia including medication, psychotherapy and their combination. Although there have been a number of reviews of medications (Davidson, 2003; Antony & Swinson, 2000), psychological treatment (Clark, Ehlers, Fennell & Campbell, 2003; Rachman, 1977) and combined treatments (Taylor, 1996; Federoff, 2001) for Social Phobia and the development of clinical guidelines (Federoff, 2001) there has been no separation of these studies to identify characteristics for optimal overall management of Social Phobia. Patients with Social Phobia are difficult to engage with psychiatric services due to fearing social situations and to date there are no published data to identify how to improve treatment engagement or adherence (Taylor, 1996; Powers, Sigmarsson & Emmelkamp, 2008).
Over 30 studies worldwide (Scholing & Emmelkamp, 1993; Stangier, heidenreich, Pietz, 2002; Clark, Ehlers, Fennell & Campbell, 2003; Powers, Sigmarsson & Emmelkamp, 2008) looking at treatment options for Social Phobia show a vast preference to use Cognitive Group Therapy or (CBT) above other treatments for Social Phobia including other psychotherapy treatments (including individual treatments) and medications. Even though medications are one of the most widely used methods to treat Social Phobia, findings have suggested that over time group therapy and the skills gained have more long lasting effects for coping and overcoming Social Phobia in the future (Friedberg & McClure, 2003; Acarturk, Cuijpars, Straten & De Graaf, 2009).
CBT is a psychotherapeutic approach that addresses dysfunctional emotions, maladaptive behaviours and cognitive processes through a number of goal-oriented, clear methodical procedures where a therapist will work either with a group of clients or one on one. CBT helps the client come to the understanding that it is their own thoughts, rather than the situations or other people that determine how they react, behave and consequently feel (Antony & Swinson, 2000).
Research comparing CBT with medications is quite vague. There are few studies that have directly compared CBT with medications. For example, Powers’ et al. (2008) meta-analytic